NR 576 Differential Diagnosis in Adult-Gerontology
Primary Care Midterm Questions and Answers
Dermatology
Q1: A 45-year-old presents with a raised truncal “herald patch” followed by scaly
plaques in a Christmas tree distribution. What is the diagnosis?
A: Pityriasis rosea
Q2: Which treatment is most appropriate for pityriasis rosea?
A: Supportive care (antihistamines, acetaminophen, natural sunlight/phototherapy);
condition resolves spontaneously in 6–12 weeks.
Respiratory
Q3: A 70-year-old with COPD presents with worsening dyspnea, purulent sputum, and
fever. What is the most likely diagnosis?
A: Acute bacterial exacerbation of COPD.
Q4: Which diagnostic test best differentiates pneumonia from COPD exacerbation?
A: Chest X-ray (to identify infiltrates).
Cardiovascular
Q5: A 62-year-old with chest pain radiating to the jaw, diaphoresis, and elevated
troponin. What is the diagnosis?
A: Acute myocardial infarction (NSTEMI/STEMI depending on ECG).
Q6: Which physical finding is most consistent with heart failure?
A: Bibasilar crackles and elevated jugular venous pressure.
Ophthalmology
Q7: A patient presents with sudden severe eye pain, blurred vision, halos around lights,
and mid-dilated fixed pupil. What is the diagnosis?
A: Acute angle-closure glaucoma.
Q8: What is the most common cause of corneal abrasions in adults?
A: Trauma or contact lens use.
Gastrointestinal
Q9: A 55-year-old with epigastric pain relieved by eating, melena, and positive H. pylori
test. What is the diagnosis?
A: Duodenal ulcer.
Q10: Which diagnostic test is most sensitive for detecting colorectal cancer?
A: Colonoscopy.
, Endocrine
Q11: A 68-year-old with fatigue, weight gain, cold intolerance, and elevated TSH. What
is the diagnosis?
A: Primary hypothyroidism.
Q12: Which lab finding confirms diabetic ketoacidosis (DKA)?
A: Hyperglycemia, metabolic acidosis, and positive serum ketones.
Musculoskeletal
Q13: A 72-year-old with hip pain, shortened externally rotated leg after a fall. What is
the diagnosis?
A: Hip fracture.
Q14: Which test best confirms rheumatoid arthritis?
A: Positive anti-CCP antibodies.
Neurology
Q15: A 65-year-old with resting tremor, bradykinesia, and cogwheel rigidity. What is the
diagnosis?
A: Parkinson’s disease.
Q16: Sudden unilateral weakness, facial droop, and slurred speech lasting >24 hours.
What is the diagnosis?
A: Ischemic stroke.
Q17: A 58-year-old with unilateral facial droop, inability to close eye, but no limb
weakness. What is the diagnosis?
A: Bell’s palsy.
Q18: Which imaging is first-line for suspected acute ischemic stroke?
A: Non-contrast CT head.
Pulmonology
Q19: A 65-year-old smoker with chronic cough, hemoptysis, and weight loss. What is
the most likely diagnosis?
A: Lung cancer.
Q20: Which test confirms asthma diagnosis?
A: Spirometry with bronchodilator response.
Cardiology
Q21: A 72-year-old with irregularly irregular pulse and no P waves on ECG. What is the
diagnosis?
A: Atrial fibrillation.
Q22: Which medication reduces stroke risk in atrial fibrillation?
Primary Care Midterm Questions and Answers
Dermatology
Q1: A 45-year-old presents with a raised truncal “herald patch” followed by scaly
plaques in a Christmas tree distribution. What is the diagnosis?
A: Pityriasis rosea
Q2: Which treatment is most appropriate for pityriasis rosea?
A: Supportive care (antihistamines, acetaminophen, natural sunlight/phototherapy);
condition resolves spontaneously in 6–12 weeks.
Respiratory
Q3: A 70-year-old with COPD presents with worsening dyspnea, purulent sputum, and
fever. What is the most likely diagnosis?
A: Acute bacterial exacerbation of COPD.
Q4: Which diagnostic test best differentiates pneumonia from COPD exacerbation?
A: Chest X-ray (to identify infiltrates).
Cardiovascular
Q5: A 62-year-old with chest pain radiating to the jaw, diaphoresis, and elevated
troponin. What is the diagnosis?
A: Acute myocardial infarction (NSTEMI/STEMI depending on ECG).
Q6: Which physical finding is most consistent with heart failure?
A: Bibasilar crackles and elevated jugular venous pressure.
Ophthalmology
Q7: A patient presents with sudden severe eye pain, blurred vision, halos around lights,
and mid-dilated fixed pupil. What is the diagnosis?
A: Acute angle-closure glaucoma.
Q8: What is the most common cause of corneal abrasions in adults?
A: Trauma or contact lens use.
Gastrointestinal
Q9: A 55-year-old with epigastric pain relieved by eating, melena, and positive H. pylori
test. What is the diagnosis?
A: Duodenal ulcer.
Q10: Which diagnostic test is most sensitive for detecting colorectal cancer?
A: Colonoscopy.
, Endocrine
Q11: A 68-year-old with fatigue, weight gain, cold intolerance, and elevated TSH. What
is the diagnosis?
A: Primary hypothyroidism.
Q12: Which lab finding confirms diabetic ketoacidosis (DKA)?
A: Hyperglycemia, metabolic acidosis, and positive serum ketones.
Musculoskeletal
Q13: A 72-year-old with hip pain, shortened externally rotated leg after a fall. What is
the diagnosis?
A: Hip fracture.
Q14: Which test best confirms rheumatoid arthritis?
A: Positive anti-CCP antibodies.
Neurology
Q15: A 65-year-old with resting tremor, bradykinesia, and cogwheel rigidity. What is the
diagnosis?
A: Parkinson’s disease.
Q16: Sudden unilateral weakness, facial droop, and slurred speech lasting >24 hours.
What is the diagnosis?
A: Ischemic stroke.
Q17: A 58-year-old with unilateral facial droop, inability to close eye, but no limb
weakness. What is the diagnosis?
A: Bell’s palsy.
Q18: Which imaging is first-line for suspected acute ischemic stroke?
A: Non-contrast CT head.
Pulmonology
Q19: A 65-year-old smoker with chronic cough, hemoptysis, and weight loss. What is
the most likely diagnosis?
A: Lung cancer.
Q20: Which test confirms asthma diagnosis?
A: Spirometry with bronchodilator response.
Cardiology
Q21: A 72-year-old with irregularly irregular pulse and no P waves on ECG. What is the
diagnosis?
A: Atrial fibrillation.
Q22: Which medication reduces stroke risk in atrial fibrillation?
